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Do we want to know?

Roberto D'Angelo1

  • 1Institute of Contemporary Psychoanalysis, Los Angeles.

The International Journal of Psycho-Analysis
|September 27, 2024
PubMed
Summary

Psychoanalytic exploration of gender-affirming interventions for youth is crucial but hindered by social and political barriers. Understanding the risks and underlying psychic pain is essential, questioning the rush towards medical transition.

Area of Science:

  • Psychoanalysis
  • Adolescent Psychology
  • Gender Studies

Background:

  • Gender-affirming interventions for youth lack robust evidence and carry significant consequences.
  • Psychoanalytic exploration is vital but constrained by societal prohibitions on inquiry.
  • Socio-political trends create barriers, framing deep exploration as conversion therapy.

Purpose of the Study:

  • To explore the psychoanalytic implications of gender-affirming interventions for youth.
  • To examine the constraints on psychoanalytic work with trans-identified youth.
  • To question the ethical considerations surrounding medical interventions for adolescents given uncertain evidence and risks.

Main Methods:

  • Psychoanalytic theoretical analysis.
  • Exploration of socio-political influences on clinical practice.
Keywords:
LGBTTransgenderdetransitionpsychoanalysistransition

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  • Critical examination of the evidence base for gender-affirming interventions.

    • Main Results:

    • Individual and social prohibitions impede thorough psychoanalytic exploration.
    • Dominant trends reinforce barriers, labeling exploration as conversion therapy.
    • Clinicians promoting interventions may discredit those exploring underlying psychic pain or risks.

    Conclusions:

    • The weak evidence base and risks necessitate a cautious approach to medical gender-affirming interventions for youth.
    • There is a need to address the psychic pain that may underlie gender dysphoria.
    • The ethical imperative to "know"—to explore uncertainties and risks—is paramount in this field.